DRUG-METABOLISM IN LIVER-DISEASE - IDENTIFICATION OF PATIENTS WITH IMPAIRED HEPATIC DRUG-METABOLISM

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  • 1 January 1978
    • journal article
    • research article
    • Vol. 75  (4) , 580-588
Abstract
Antipyrine half-life (AP t1/2) was measured in 62 patients with liver disease and 10 control patients to ascertain possible factors in identifying patients with abnormal drug metabolism. Antipyrine metabolism was normal or marginally impaired in patients with compensated cirrhosis or acute hepatitis; it was frequently abnormal in those with chronic active hepatitis or advanced alcoholic liver disease. A high degree of correlation was found among AP t1/2 and prothrombin time, hepatic encephalopathy and ascites. Of patients with severely impaired drug metabolism, 80% had 1 or more of these features. The severity of histological changes in liver biopsies was of additional help in predicting impaired drug metabolism. Concurrent drug ingestion enhanced antipyrine metabolism in most patients with liver disease and in control patients. Inadequate diet was associated with prolongation of AP t1/2, but other environmental factors, i.e., alcohol ingestion, cigarette smoking and coffee consumption did not affect rates of drug metabolism in patients with liver disease. These factors allow qualitative predictions of the hepatic drug metabolism rate in patients with liver disease, as assessed by the AP t1/2.